In a recent study, 92% of dental implants were found to have survived the twenty-year mark — an impressive track record for any dental restoration.

Still, implants do fail, although rarely. Of those failures, tobacco smokers experience them twice as often as non-smokers. The incidence of early failure (within the first few months after implantation) is even higher for smokers.

Early implant failure typically happens because the titanium implant and the surrounding bone fail to integrate properly. Titanium has a natural affinity with bone — the surrounding bone will attach and grow to the titanium in the weeks after surgery, forming a strong bond. An infection around the implant site, however, can inhibit this integration and result in a weaker attachment between bone and implant. This weakness increases the chance the implant will be lost once it encounters the normal biting forces in the mouth.

Smokers have a higher risk of this kind of infection because of the way tobacco smoke alters the environment of the mouth. Inhaled smoke burns the mouth’s top skin layers and creates a thick layer of skin called keratosis in its place. Smoke also damages salivary glands so that they don’t produce enough saliva to neutralize the acid from food that’s left in the mouth after eating. This creates an environment conducive to the growth of infection-causing bacteria. At the same time, the nicotine in tobacco can constrict the mouth’s blood vessels inhibiting blood flow. The body’s abilities to heal and fight infection are adversely affected by this reduced blood flow.

The best way for a smoker to reduce this early failure risk is to quit smoking altogether a few weeks before you undergo implant surgery. If you’re unable to quit, then you should stop smoking a week before your implant surgery and continue to abstain from smoking for two weeks after. It’s also important for you to maintain good brushing and flossing habits, and semi-annual dental cleanings and checkups.

Although smoking only slightly raises the chances of implant failure, the habit should be factored into your decision to undergo implant surgery. Quitting smoking, on the other hand, can improve your chances of a successful outcome with your implants — and benefit your life and health as well.